Address lack of home health care workers

All older adults in Maryland deserve access to quality health care and community support. However, this is currently not attainable as there is a blatant mismatch between the supply of home health aides and the demand. In fact, we are short 40% of aides to meet the needs of our community and as such are in the midst of a home health care crisis (“Nurses on pandemic front lines look to refill their ‘empty cup,’ ” May 6).

The root cause of this crisis is two-pronged.

First, with the advances in public health and medicine, more individuals are able to live to an older age. By 2040, Maryland is projected to have over 1.8 million citizens who are 60 years and older. Based on a study conducted by the U.S. Department of Health and Human Services, upon turning 65, over one in four men and one in three women require at least one or more years of long-term supports and services. For Maryland, this could mean up to 500,000 older adults (which could fill over 10 Camden Yards) requiring assistance with their daily tasks and chronic health conditions.

Second, home health aides have high turnover and burnout rates due to poor financial, occupational and psychosocial struggles. In Maryland, home health aides earn a median hourly wage of $13 and a median annual income of $22,700. They have long been undervalued and overworked, and their workforce inequity has only been magnified throughout the COVID-19 pandemic. This lack of a safe working environment is not only hazardous for the workers but also jeopardizes the quality of care delivered. Thus, this pressing issue needs to be promptly addressed as it affects our population’s health and is unsustainable.

I propose two policy alternatives that could help stabilize the workforce and provide better healthcare for our older adults.

First, we need to show that we care for and value our workers through increased wages. Studies have shown that increasing pay will also increase the recruitment and retention of workers. More than 20 states have moved toward this goal by implementing a Medicaid wage pass-through program for direct care workers, which sees as much as a 12% increase in compensation per hour and promotes a more sustainable workforce. By supporting our workers, we will also increase the number of older adults who are able to age successfully in the community and decrease the overall health expenditure for Maryland through reduced nursing home admissions, hospitalizations, and psychosocial struggles.

Second, the recent 2022 state legislative session passed and enrolled House Bill 625/Senate Bill 440 to create a commission to study the health care workforce crisis in Maryland. Although this is a great step forward, research studies merely provide evidence-based data to help inform change. As such, we need to carry this momentum forward and hold the task force accountable for not only performing a thorough study, but also translating their findings into actionable policies.

Meanwhile, we need to raise awareness that the home health aide shortage will continue to worsen over time and maintaining the status quo is not only unsustainable, but is also unsafe for the workers, older adults and our community.